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摘要: 垂体腺瘤是较常见的神经内分泌肿瘤,多为良性,但其高分泌激素或大腺瘤干扰腺垂体及周围组织器官的正常功能,严重影响患者的健康和预后。多学科参与的规范诊疗是垂体腺瘤临床应对的重要原则。2017年世界卫生组织第4次修订了垂体腺瘤的病理诊断分类,高危垂体腺瘤和难治性垂体腺瘤依然是临床诊治的难点,存在诸多挑战,而垂体腺瘤的发生机制和潜在治疗靶点亦有待进一步揭示。本文系统总结了垂体腺瘤的发病机制和临床诊治进展。
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关键词:
- 垂体腺瘤 /
- 难治性垂体腺瘤 /
- 多学科综合治疗协作组
Abstract: Pituitary adenomas (PAs) are a kind of neuroendocrine neoplasm(NEN)and mostly benign. However, the hyper function of adenohypophysis and the compression to surrounding tissues and organs are often seriously presented in macroadenomas. The standardized diagnosis and treatment of PAs by multidisciplinary team is important. In 2017, the World Health Organization (WHO) revised the pathological diagnosis classification of PAs for the fourth time. High risk PAs and refractory PAs are still challenge in clinical diagnosis and treatment. The mechanism and potential therapeutic target of PAs need to be further revealed. The pathogenesis and clinical diagnosis and treatment of pituitary adenomas were reviewed.利益冲突:无 -
[1] Gittleman H, Ostrom QT, Farah PD, et al. Descriptive epidemiology of pituitary tumors in the United States, 2004—2009[J]. J Neurosurg, 2014, 121:527-535. doi: 10.3171/2014.5.JNS131819 [2] Orija IB, Weil RJ, Hamrahian AH. Pituitary incidentaloma[J].Best Pract Res Clin Endocrinol Metab, 2012, 26: 47-68. doi: 10.1016/j.beem.2011.07.003 [3] Fernández-Balsells MM, Murad MH, Barwise A, et al.Natural history of nonfunctioning pituitary adenomas and incidentalomas: a systematic review and metaanalysis[J]. J Clin Endocrinol Metab, 2011, 96:905-912. doi: 10.1210/jc.2010-1054 [4] Vierimaa O, Georgitsi M, Lehtonen R, et al. Pituitary adenoma predisposition caused by germline mutations in the AIP gene[J].Science, 2006, 312: 1228-1230. doi: 10.1126/science.1126100 [5] Schöfl C, Jürgen H, Michael D, et al. Frequency of AIP gene mutations in young patients with acromegaly: a registry-based study[J].J Clin Endocrinol Metab, 2014, 99: E2789-E2793. doi: 10.1210/jc.2014-2094 [6] Yao Y, Liu Y, Wang LJ, et al. Clinical characteristics and management of growth hormone excess in patients with McCune-Albright syndrome[J].Eur J Endocrinol, 2017, 176: 295-303. doi: 10.1530/EJE-16-0715 [7] 王林杰, 王鸥, 潘慧, 等.多发性内分泌腺瘤病1型合并垂体腺瘤的临床特点[J].中华神经外科杂志, 2016, 32:266-269. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhsjwkzz98201603010 [8] Tatsi C, Stratakis CA.The Genetics of Pituitary Adenomas[J].J Clin Med, 2019, 9: 30. doi: 10.3390/jcm9010030 [9] Duong CV, Emes RD, Wessely F, et al. Quantitative, genome-wide analysis of the DNA methylome in sporadic pituitary adenomas[J].Endocr Relat Cancer, 2012, 19: 805-816. doi: 10.1530/ERC-12-0251 [10] Osamura RY. Tumours of the Pituitary Gland[M]//Lloyd RV, Osamura RY, Klöppel G, et al.WHO Classification of Tumours of Endocrine Organs.4th ed. Lyon: International Agency for Research on Cancer, 2017: 11-64. [11] 袁仙仙, 朱惠娟.2017年世界卫生组织垂体肿瘤病理分类变化及临床意义[J].中华内分泌代谢杂志, 2018, 34:623-626. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhnfmdx201807019 [12] Erickson D, Scheithauer B, Atkinson J, et al. Silent subtype 3 pituitary adenoma: a clinicopathologic analysis of the Mayo Clinic experience[J].Clin Endocrinol (Oxf), 2009, 71: 92-99. doi: 10.1111/j.1365-2265.2008.03514.x [13] Raverot G, Vasiljevic A, Jouanneau E, et al. A prognostic clinicopathologic classification of pituitary endocrine tumors[J].Endocrinol Metab Clin North Am, 2015, 44: 11-18. doi: 10.1016/j.ecl.2014.10.001 [14] Villa C, Vasiljevic A, Jaffrain-Rea ML, et al. A standardised diagnostic approach to pituitary neuroendocrine tumours (PitNETs): a European Pituitary Pathology Group (EPPG) proposal[J].Virchows Arch, 2019, 475: 687-692. doi: 10.1007/s00428-019-02655-0 [15] Raverot G, Burman P, McCormack A, et al. European Society of Endocrinology Clinical Practice Guidelines for the management of aggressive pituitary tumours and carcinomas[J].Eur J Endocrinol, 2018, 178: G1-G24. doi: 10.1530/EJE-17-0796 [16] Ho KKY, Fleseriu M, Wass J, et al. A tale of pituitary adenomas: to NET or not to NET: Pituitary Society position statement[J].Pituitary, 2019, 22: 569-573. doi: 10.1007/s11102-019-00988-2 [17] Nasi D, Perano D, Ghadirpour R, et al. Primary pituitary neuroendocrine tumor: Case report and literature review[J].Surg Neurol Int, 2017, 8: 101. doi: 10.4103/sni.sni_450_16 [18] Di Ieva A, Rotondo F, Syro LV, et al. Aggressive pituitary adenomas--diagnosis and emerging treatments[J].Nat Rev Endocrinol, 2014, 10: 423-435. doi: 10.1038/nrendo.2014.64 [19] 马四海, 姚勇, 代从新, 等.替莫唑胺治疗难治性垂体腺瘤一例报告并文献复习[J].中华神经外科杂志, 2011, 27:484-488. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhsjwkzz98201105018 [20] 中国垂体腺瘤协作组, 中华医学会神经外科学分会.中国难治性垂体腺瘤诊治专家共识(2019)[J].中华医学杂志, 2019, 99:1454-1459. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhyx201919005 [21] Goshtasbi K, Lehrich BM, Abouzari M, et al. Endoscopic versus nonendoscopic surgery for resection of pituitary adenomas: a national database study[J].J Neurosurg, 2020. doi:10.3171/2020.1.JNS193062.[Epub ahead of time]. [22] Castinetti F.Radiation techniques in aggressive pituitary tumours and carcinomas[J].Rev Endocr Metab Disord, 2020, 21: 287-292. doi: 10.1007/s11154-020-09543-y [23] Zhu Y, Shaninian H, Hakimian B, et al.Temodar:novel treatment for pituitary carcinoma[J].US Endocr Soc, 2004, 138:43-45. [24] Raverot G, Burman P, McCormack A, et al. European Society of Endocrinology Clinical Practice Guidelines for the management of aggressive pituitary tumours and carcinomas[J].Eur J Endocrinol, 2018, 178: G1-G24. doi: 10.1530/EJE-17-0796 [25] Lizzul L, Lombardi G, Barbot M, et al. Long-course temozolomide in aggressive pituitary adenoma: real-life experience in two tertiary care centers and review of the literature[J].Pituitary, 2020, 23: 359-366. doi: 10.1007/s11102-020-01040-4
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